VA Bridging Rural Care Divide With ATLAS Program

Presenting at a demonstration of the newly launched ATLAS program on Capitol Hill, representatives from the Department of Veterans Affairs detailed the telehealth initiative’s origins and its role in bridging the rural care divide.

The VA has long sought to bring more comprehensive care to veterans living in rural areas, with one third of all veterans served by the agency — approximately 5.2 million — living in rural parts of the country. This has caused particular difficulties for veterans with persistent or specialized care needs, often requiring difficult or outright unfeasible travel distances to reach the nearest available caregiver within the VA network.

VA executives behind the ATLAS Telehealth initiative, or Advancing Telehealth through Local Access Stations, told GovernmentCIO Media & Research they hope it will help bridge the rural health care divide for America’s veterans.

Dr. Kevin Galpin, executive director of VHA Telehealth Services, expressed particular optimism about ATLAS’ potential to provide care for veterans with limited internet connectivity.

“There are veterans who don’t have internet, or sufficient technology, to take advantage of these services,” Galpin noted about the VA’s success in providing telehealth services for veterans with ready access to broadband.

This has presented a particular quandary for VHA.

“We really need to look at other options to overcome the digital divide in this country,” Galpin said. “If we can’t get care in their home, we can provide it in the local community.”

The centerpiece of the ATLAS program is its remote telehealth exam rooms that allow veterans to book appointments outside their home. Galpin detailed this has involved planning exam rooms in especially convenient, community-centric locations, including “libraries, veteran service organizations and even Walmart.”

The ATLAS telehealth rooms have been designed with comfort in mind, including settings that create soundscapes of the seaside or lighting reminiscent of a sunset, Galpin said. Creating this sort of accommodating, private space is especially crucial.

“Not every veteran has a therapeutic environment at home, and it’s comforting for them to be able to come to a community center,” Galpin said.

Private-public partnerships have been crucial for ATLAS’ development, with the initiative being launched in December 2018 with considerable support from Philips, Galpin said. The program’s development has been rapid over the intervening months.

“We had a ribbon cutting for our first [telehealth room] last month, and we have plans for nine pilot sites this year,” he said.

The ATLAS program could improve the care experience for a considerable breadth of the VA patients.

“Last year, about 15% of all veterans who got care from the VA got some portion remotely,” Galpin said. The ATLAS program has been designed with intent to scale. The VA is concurrently developing an application to help veterans locate their nearest ATLAS site by zip code, he added.

The ATLAS program fits with the VA’s expansion in its behavioral health services and PTSD treatment. “This is perfect for any kind of talk therapy,” Galpin said, and especially helpful in smaller communities where the local counselor might be a personal acquaintance.

In a subsequent interview, Executive Advisor to the Secretary of VA Deborah Scher tied the ATLAS program directly to the agency’s central mission of providing care for all of America’s veterans.

“Nineteen percent of Americans live in rural communities, 25% of veterans live in rural communities, and 33% of the veterans we serve live in rural communities,” she said.

VA leadership designed the ATLAS program with a conscientiousness toward improving rural care, Scher continued.

“As we sat down with our colleagues in the Office of Connected Care, they highlighted two barriers in bridging the digital divide,” she said. “One is that there are veterans who would like to receive their care through video telehealth but can’t afford an unlimited data plan.”

This quandary was resolved by the VA coordinating with internet service providers to zero-rate the agency’s video connect app, offering connectivity free of charge, she said.

Scher holds up the ATLAS program as the second core component in bridging the rural care divide.

“There are veterans who live in areas with no broadband, so it doesn’t matter what kind of data plan they get,” she said. “We started to think about how the VA extends our reach without extending a physical footprint.”

Scher described foundation for the ATLAS program. Upon developing a comprehensive map of veterans in rural areas with limited access to care, the VA began pursuing partnerships with Walmart to pilot ATLAS sites in local communities while establishing a simultaneous collaboration with American Legion and Veterans of Foreign Wars to begin establishing ATLAS sites in their meeting halls. This has created a corresponding map of potential ATLAS sites that will help veterans in more remote locations access telehealth care, she added.

Hear more about ATLAS from VA leaders at our upcoming Nov. 7 Veterans Digital Transformation Breakfast event at the Newseum.